The antiviral drug that treats COVID-19, Paxlovid, must be taken within five days of the onset of symptoms. To expand rapid access to the medication, the U.S. Food and Drug Administration revised the Emergency Use Authorization for Paxlovid in July to authorize state-approved pharmacists to prescribe it directly.
“We saw very low uptake and even within the pharmacy we only saw the drugs on the shelves because the prescriptions didn’t come in,” said Richard Dang, president of the California Pharmacists Association. “There are a wide variety of different reasons why that could be: lack of information, but most likely would be lack of access to a provider who can evaluate the individual and prescribe the medication within that five day period.
Now, more than a month after the new FDA approval, it is still not easy for many eligible patients to get a Paxlovid prescription directly from their pharmacist.
Challenges for patients
Before a pharmacist can prescribe a Paxlovid prescription, they must first perform a full evaluation that will require you, the patient, to provide:
- Electronic or printed medical records less than 12 months old, including the most recent laboratory blood test reports for the state licensed pharmacist to check for kidney or liver problems. (State licensed pharmacies may also receive this information through a consultation with the patient’s health care provider)
- A list of all medications you are taking, including over-the-counter medications, so the state-licensed pharmacist can screen for drugs with potentially serious interactions with Paxlovid.
“So with all that in mind, it won’t be as easy as walking into a pharmacy and getting a prescription” Dang said.
And meeting these requirements can be more difficult for some of our most vulnerable members of the community.
“Unfortunately, socially vulnerable populations, such as those minority groups who may be undocumented or who do not have regular access to health care, may not have that updated data,” he said.
Challenges in the pharmacy
It’s not just patients who face challenges. Many pharmacies may not be able to prescribe Paxlovid due to COVID-related staffing issues and how much extra time it takes to evaluate patients. Sanjay Patel runs Hallers Pharmacy in Fremont, California. His pharmacists will start prescribing Paxlovid, but he says it takes at least 20 to 30 minutes to do a full evaluation, which is the best-case scenario.
“With all the questions we need to ask, check out the documentation and make sure the labs are okay,” he said.
In March, the research unit first told you about a state survey that found that 91% of chain pharmacists and 37% of independent pharmacists didn’t have enough staff to ensure adequate patient care – and this was before pharmacists were allowed to add the extra prescription of the antiviral.
WATCH: Harmful, deadly pharmacy errors persist during pandemic, according to complaints from CA
“Not all pharmacists and pharmacies will offer this service,” Dang says.
The research unit contacted CVS, Walgreens and Rite Aid. They all said they don’t currently have California pharmacists prescribing Paxlovid, although they dispense the drug if the patient has a prescription from a doctor.
WATCH: Number of CA pharmacy error investigations spiked during COVID
In a statement, the National Association of Chain Drug Stores called the FDA’s new license “an extremely important review,” but wants the federal government to “take the necessary next steps to support pharmacy-based reviews” — meaning pharmacy fees for patient evaluations are reimbursed.
To find out if your pharmacy prescribes Paxlovid, you must first call the location. You can also find a nearby Test to Treat program, which are government-supported sites set up to test and treat patients for COVID-19.
If you get COVID, how do you get the pills to treat it? The FBI recently started allowing people to bypass their doctor and go straight to the pharmacist for paxlovid. But it’s not as easy as it sounds. That reports investigative journalist Candice Nguyen.